Theophylline (Theo-Dur) tablets are prescribed for a client with chronic airflow limitation, and the nurse instructs the client about the medication. Which statement by the client indicates a need for further teaching?
A. “I will take the medication on an empty stomach.”
B. “I will take the medication with food.”
C. “I will continue to take the medication even if I am feeling better.”
D. “Periodic blood levels will need to be obtained.”
Correct Answer: A. “I will take the medication on an empty stomach.”
Theo-Dur is a bronchodilator. The medication should be administered with food such as milk and crackers to prevent GI irritation. Patients should consistently take theophylline either in a fasting state or with food (as this helps to maintain a more consistent serum drug concentration).
Option B: Take each morning around the same time and avoid taking it at night (after the evening meal). In patients whom a higher dose is required (13 mg/kg or greater than or equal to 900 mg, whichever one is less), should take the medication less than 60 minutes before a high-fat meal (as a significant increase in the peak serum concentrations and absorption could occur).
Option C: Cautiously administer theophylline in a patient who has consumed large amounts of foods or drinks with high caffeine content, as this could potentially increase the risk of side effects of theophylline. The dose gradually increases until achieving therapeutic plasma concentrations. This approach reduces side effects.
Option D: Serum theophylline concentrations should be checked after the initiation of therapy, before increasing dose, and if any signs or symptoms of toxicity appear. For patients taking oral treatment, monitor serum concentrations at 6-month intervals for rapidly developing children and at annual intervals for all other patients (if their symptoms are well controlled).
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